Dallaire warns of soldiers’ stress

Retired general Senator Roméo Dallaire has been a vocal supporter of raising awareness for veterans’ mental health since his own attempted suicide — a consequence of his experiences in the Rwandan genocide in 1994, where he was commander of the UN peacekeeping force. He spoke to John Ivison.

Q. Do you classify your own experience as an operational stress injury (OSI)?

A: Yes. When I got back, I’d spent a year in Africa, of which over three months was genocide and civil war. I was given less than three weeks leave and was told by my superiors the theory at the time was work hard and it will go away. There was absolutely nothing at the start and it only started to build up later. I completely crashed in 1998 and was released medically in 2000.

Q. Do you expect the incidence of OSI cases to rise as a result of the end of the mission in Afghanistan?

A. We now have a scenario where individuals operating on a high level of adrenalin are coming home. They have sustained a hell of a lot of stress and so have their families. They’ve put on the back-burner a lot of pent-up hurt. What happens when the war is over? They’ve got this well-established level of high intensity that, all of a sudden, has no aim to it. At least when World War Two was over, we coud say we won but in this case, they’re coming back and the war is not over and there is no cry of victory. What they have is a sense that the mission is not really finished. They’re not coming back to a victory parade; they’re coming back, having been relieved of combat duty by the Americans, which in itself is not the most buoyant of scenarios. Now they’re coming back to garrison to lick their wounds and, by the by, they’re coming back to budget cuts. I speak now purely from experience — when you’re finally out of that high intensity rhythm, you go down into a level of normalcy and it’s goddam near like pulling the plug on a lamp. You can see people dropping really fast from being a pillar of strength to suddenly having family problems. The individual’s hurt and pain that he’s been able to smother, well now he’s got time to think about it. I contend that when they say an army comes back to garrison to lick its wounds, that’s exactly what happens.

Q. Is the system geared to coping with OSI?

A. Up until 1997, we’d lost all capabilities of treating operational stress because we’d been at peace for so long. But by 1997, there were enough of us casualties, and I’d gone public, that the forces started to build up the capabilities to treat a whole new generation of veterans for which they had no skills. The realization emerged that this injury needed as much a sense of urgency for treatment as a physical injury, that OSI had just as devastating an impact as losing an arm or a leg, which was a revolution in the forces. Professional therapists got out of their offices and into the faces of soldiers to sell their wares and the forces started to look at personnel policies on how to handle these people without simply throwing them out because they weren’t performing well anymore.

Q. Is there still a stigma associated with OSI? Do soldiers try to hide their symptoms?

A. There is a cocoon in the Canadian Forces, a Darwinianism. You get high performing people who expect high levels of performance from others. They can be quite ruthless on people who can’t meet those levels, which they have to be. You can’t drag out people who can’t perform or you put the mission at risk. Culturally, we are a very visual bunch of people, we work off maps and technology. That makes it harder to comprehend a non-visual injury. But there has been a massive cultural shift. Calling it an ‘operational stress injury’ not a ‘mental health problem’ has been important — it broke the code for a lot of troops in giving them a sense they were not suffering from a dishonourable injury but a recognized injury that could have fatal consequences — i.e. suicide.

Q. Where is the system working and where is it falling down?

A. We’ve built up a pretty decent prevention program. We have created a transition stage on the way home, where guys can get used to clean sheets, decent meals and showers and where there is no noise or fear of war. This lets them come down to reasonable levels before they move back home. During this time, they can be evaluated by a formal program that has been recognized by the Americans as the most effective of any of the forces we know of. They’ve built up a pretty sophisticated methodology of identifying whether an individual is injured. Sometimes the troops find it annoying but it has proven itself quite worthy.

The deficiencies are on the treatment side, where we are still weak. It’s a question of whether the veteran is going to get the services he or she needs. I would contend that we’re still weak in bringing to the veterans the professional therapists, in particular psychologists, they need.

Another weakness is the failure to cover the families. Although the member is injured, so is the family. We have a hard time getting therapy for members of the forces but it’s even harder for the family member, who is caught in the fight between the feds and provinces over responsibility. It’s time the forces and Veterans Affairs Canada started to take care of the families — you hire the individual, you hire the family. If you put that individual under duress, there is no doubt that the family will suffer the consequences.

From my own personal example, my eldest son was 15….What happens when Dad comes home and he’s not the same guy? He thinks differently, he’s unpredictable, sensitive and stressed. How in hell do they adjust to that, especially if the spouse has not been able to be supportive or not sought support from the family support people? She’s probably in rough shape too, which exacerbates the scenario for children.

The cost of war on the human side is expensive — and much of it comes after the war.